Provider Demographics
NPI:1588600852
Name:SMITH, NORMAN JOE (MD)
Entity Type:Individual
Prefix:
First Name:NORMAN
Middle Name:JOE
Last Name:SMITH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:310 HOSPITAL DR
Mailing Address - Street 2:SUITE 210
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31217-3895
Mailing Address - Country:US
Mailing Address - Phone:478-746-1879
Mailing Address - Fax:478-743-7588
Practice Address - Street 1:310 HOSPITAL DR
Practice Address - Street 2:SUITE 210
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31217-3895
Practice Address - Country:US
Practice Address - Phone:478-746-1879
Practice Address - Fax:478-743-7588
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-22
Last Update Date:2021-11-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA014568207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00170497AMedicaid
GAD42204Medicare UPIN